To make a long story somewhat shorter, this OP came about as a result of my dentist appointment coming up later this week (and yes, I have already spoken to my primary physician and gotten his advice, and have a call in to my gyno as well).
Because I was diagnosed with mitral valve prolapsegoing on 20 years ago, since then I have been advised to premedicate before dentist appointments with 2000 mg of amoxicillin. When I went to fill the prescription, along with my birth control pills, for the very first time in all these years the pharmacist advised me that yes, even a single dose of certain antibiotics may diminish the effectiveness of birth control pills, and so I should use a backup contraceptive method for the rest of my cycle.
So I conveyed all this to my primary doctor, and his (IMO quite sensible) feedback was a) he’s never heard any kind of loud murmur in examining me over the past 15-ish years, including multiple EKGs, so b) he thinks I am fine without premedicating for a simple dental cleaning, and c) one of these days (no rush) I should get an echocardiogram so we can decide once and for all what the deal is with my mitral valve (the doctor who initially diagnosed it – not my current doctor - was an idiot, and I have no idea where she is anymore, anyway, and the HMO doesn’t exist anymore, and I have no idea where those records are, and it was a long time ago, in any case).
So my question is: my current doctor has never performed an echocardiogram on me, but he has performed multiple routine EKGs. Nothing weird has ever turned up in all this time. So how likely is it that an echocardiogram will turn up something that didn’t show on an EKG, and why? What kinds of issues are better diagnosed by one technique vs. the other?
They measure different things.
EKG measures the heart’s electrical output. It can indicate many problems, including poor oxygenation of the heart muscle. Echo is a test to “look” at the heart while it is in operation - it’s much more of a “mechanical” test (it can even see leaky valves). So, my doctor has used both to diagnose my issues.
To “echo” what beowulff has said, the echo is more about what your heart looks like physically when it’s beating. They can look for things like ejection fraction (measure of how well it’s moving blood with each beat) and can see the physical action of the valves.
An EKG is just how the electrical currents are running through the heart’s muscle. I can show places of dead muscle (post heart attack, f’rinstance), and can show things like arrhythmias or scary electrical patterns that can provide warnings that the electricity isn’t doing exactly what you want it to do with each beat.
Thanks, guys - I remember the tech letting me watch while she did the echo, and it was pretty cool. But the explanations make sense. If anyone else feels like elaborating, linking to cool pictures, or anything, please go right ahead.
And now, the joy of figuring out how expensive the echo will be with our new and suckier $1,000 annual deductible…
My experiences with echos is that they aren’t usually too bad, cost-wise. But frankly, I got to a place where anything that cost less than 1000 dollars struck me as not too bad.
It’s not always easy to hear a heart murmur as long as it’s not a huge one. My dad even went into the Army (where a heart murmur on the intense physical exam before Basic Training would have gotten him kicked out), and years and years of doctors’ appointments later, in his late 40s, his GP said he thinks he hears a heart murmur. Sure enough, apparently his childhood bout of rheumatic fever damaged one of his heart valves.
Yeah, I don’t think I’ve even had any symptoms since grad school finals, which was in 1995…so I wouldn’t be surprised if the echo didn’t pick up anything. And even when I did first show symptoms, the treatment was worse than the problem; they gave me beta blockers, which made me dizzier than the palpitations did. Eventually the symptoms just went away.
And update - my gyno says one dose of antibiotics woudn’t have been an issue anyway, and was surprised that the dentist hadn’t ditched the premedicating years ago. But I guess I should do the echocardiogram at some point anyway.
I came out of a bout of food poisoning with palpitations in my late 30’s. They were premature atrial contractactions, not pleasant but not life interferring either. I also found beta-blockers to be helpful with the symptoms, but the ‘side’ effects made them more troub le than they were worth. My symptoms just went away eventually, too.